ageless beauty, timeless skin: Sensitive Skin: Q & A

Several years ago I was approached by About Health magazine to contribute to an article about sensitive skin. I don’t recall if they ever used my information, but I wanted to make their questions and my answers available to you. If you have sensitive skin, the more information you have the better.

We hear a lot about “sensitive skin,” but definitions appear to vary considerably. Is there a clinical definition, an FDA definition, a general consensus on the condition, possible causes, symptoms and treatment?

I don’t know about a “clinical definition” for sensitive skin. I would define sensitive skin as skin that is easily irritated. In my [now 30] years of experience, I have found sensitive skin to fall under the following categories:

Touch sensitive skin: This is skin that reacts by simply touching it. The reaction is usually redness, making the skin look irritated. Generally, this kind of sensitivity does not cause pain. In many cases the person with this type of sensitivity doesn’t know their skin has turned red after touching it.

Product sensitive skin: This is skin that is sensitive to products, whether skin care or hair care products; some skin can even be sensitive to laundry detergents or fabric softeners. This type of sensitivity usually is experienced as skin that feels itchy, irritated, and turns red. Allergic dermatitis and contact dermatitis (both inflammatory skin conditions) could be considered the outcome of product-sensitive skin.

Capillary sensitivity: This is when the capillaries (the small—and weak—blood network to the skin of the face) get damaged from the environment, products (like retinoic acid and alpha hydroxy acids/AHAs), strong acid peels, heat (sun and/or hot water), and simply time.

What are common symptoms?

Redness, irritation, burning, stinging, itching, or an overall uncomfortable feeling can be symptoms of sensitive skin.

What steps do you recommend to a client who suspects sensitive skin?

Determining which kind of sensitivity is crucial to treating and living with sensitive skin. With product-sensitive skin sometimes simply eliminating the offensive product can alleviate the condition. Figuring out which products may be causing the sensitivity is the first step to helping this skin type.

If you have sensitivity due to capillary damage, you must take steps to avoid certain behaviors. Not using anything hot or cold on the skin is very important. That includes the hot water coming from the shower, steam and steam rooms, along with splashing with hot and/or cold water. Any extremes in temperature can further the sensitivities and cause irritation.

Are underlying conditions such as eczema, rosacea, or dermatitis often causes of sensitive skin?

Yes. These conditions make your skin feel sensitive on one level or another. All of those conditions involve inflammation. Inflamed skin usually is very sensitive, whether it be from a short-lived issue like eczema (a common dermatitis) or a more long-term condition such as rosacea.

Does sensitive skin generally differ from allergic skin?

This depends on the nature of the sensitivity. You could be allergic to certain products or ingredients in products which make your skin inflame or simply feel sensitive. I would say that not all sensitive skin is allergic skin but probably most allergic-type skin will feel sensitive on some level.

How prevalent is sensitive skin? I’ve read of surveys showing as many as a third to half of all people have heightened skin sensitivity, notably on the face. How does this proportion compare with your knowledge and experience?

I find many people think they have sensitive skin and after further investigation, they are simply using products that are irritating their skin. After removing the offending products, many clients find their sensitive skin is a thing of the past.

In my practice, the most common cause for this skin condition is sensitivity due to capillary damage. Most often this is caused by the use of hot water on the face along with too much sun exposure. Capillaries are weakened by heat, which will then exacerbate any obvious or underlying sensitivity issues that were present.

Is sensitive skin more common among women?

Women generally use more products on their hair and faces than men do, although this is certainly changing. Women are more likely to have sensitivities due to thinner, more fragile skin. However, because a man is scraping a sharp object (a razor) across his face on a daily basis, this alone can cause sensitivities. Add to that products he may be sensitive to, and this person can definitely complain of sensitive skin. I also think a woman is more apt to complain verbally if her skin is irritated—more so than most men do.

Is sensitive skin often overlooked? If so, why?

I don’t think sensitive skin is overlooked; I think the causes are not generally investigated. Not thoroughly enough that is. Sometimes the sensitivity can be alleviated or at least lessened by simply figuring out what is causing your skin to feel sensitive. I think those people with sensitive skin let it be known.

Are those with sensitive skin reluctant to get treatment? If so, why?

I find people who have sensitive skin tend to not get facials. They are literally afraid that what goes on in a treatment might “hurt” and cause even more sensitivity. And in some instances, this is true. However, with a skilled aesthetician who is knowledgeable about sensitivities and who is using a quality product known to not cause sensitivities in her clients, facials can be wonderful treatments to receive.

Could you please tell me about treatments? Are certain products better for sensitive skin? Do some products or ingredients aggravate it?

Peels and acidic compounds are going to irritate skin and therefore can cause sensitivities. Glycolic peels are popular facial procedures. If you have sensitive skin—watch out! Almost all alpha hydroxy acid (AHA) products and typical peels are going to cause sensitive skin to feel more sensitive.

What should those with sensitive skin look for when checking a label? So many products are now labeled “natural.” Is “natural” really better for sensitive skin or is that a myth?

The only way to truly know if you are going to be sensitive to a particular product is to try it and see. I definitely recommend understanding the return policy wherever you are purchasing products. If you have sensitive skin, you are more likely to have to return something. So don’t waste your money in a salon or store that refuses to give you a full refund if you are unable to use its products.

Fragrance as an ingredient can be irritating, even to those without true sensitive skin, so that is always an ingredient to avoid. Fragrance is generally not found in “natural” products, but that is not always the case. With the thousands of skin care products and companies out in the marketplace, it is next to impossible to recommend a specific product—or even ingredients. Every skin and sensitivity is going to react differently to products. As I said, it may involve some trial and error before someone finds the right fit for their particular skin.

I will reiterate what I have said in previous articles: you must first determine your skin type then look for products—in this case products specifically for sensitive skin. Are you oily and sensitive? True-dry and sensitive? And what are the characteristics of your particular sensitivities? These distinctions are very important to understand; once you know more details about your skin, you will be better armed when looking for products to use.

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